Contact Wounds: A War Surgeon's Education

Prodrome Contact Wounds

Life’s passage is peaceful only for the fortunate. For those of us who become surgeons it is a search for sureness, amidst potential missteps and knife-edge decisions. Each of these situations leaves marks – contact wounds – that signpost a physical and emotional journey. This one begins with a colonial childhood, caught between old conflicts and new unrest. It takes in riots, wars, tropical medicine, documentary film-making, forensic investigations, a jungle search for a missing friend and the murderous streets of Baghdad.

The important things cannot be taught in any medical school. Learning to be a war surgeon is a process of stalking and studying the enemy, death, in order that it may be combated. Such a journey is in the nature of all mythical quests, involving obstacles and digressions, the lure of enlightenment and an implacable foe. It is an education in uncertainty and rootlessness, so that our work and our journeying become an attempt to define our place in the world.

Contact Wounds is an account of these travels, the paths taken and the price paid. Those of us who’ve been there are all wounded more or less, we have all left parts of ourselves behind. Perhaps none of us was intact to begin with. There’s the questionable motivation for voluntarily putting oneself in harm’s way; less through bravery or altruism than in flight from some greater loss. We search for completeness in the land of the maimed.

Yet there is a simplicity to existence in those extreme places, a sense of purpose, that can be hard to find in everyday life. This book charts that elusive clarity. It is also a testament to family destiny – for the heritage of our past plays itself out through us, moving our hearts and hands – and to survival, my own and that of the people I’ve tried to save. Finally, perhaps, it is a dream of the possibility of homecoming.

1

Hereditary Conditions

I used to think we were unlucky that we hadn’t had a proper War, and looked for its traces all around me. The buildings along the beachfront were graceful blocks of flats, their corners rounded like an old radio. They had names that I’ve forgotten, but they held a particular charm for me because, as the adults said so casually, they were ‘prewar’; they had seen history. I imagined cocktail parties on those balconies, guests looking up at the sound of bombers overhead. In truth there hadn’t been any bombers over Durban, at least none that flew in anger or rained incendiaries on the town below. The anti-aircraft guns on the Bluff did open up one night in 1941 on an empty sky and a house was demolished by a falling shell; a bit of a joke, really.

But the war had left its mark here, in the names scored on the memorial near the city hall, and grey ships loaded with tanks and men had once sat off the harbour mouth, forming convoys against the enemy submarines that might be stalking them against the imperfect beachfront blackout. My parents and their friends used to talk about those times as we sat on the beach, watching the deepwater swimmers out by the shark-nets. Stories about dancing at the Cosmo Club on leave, getting insults from the Afrikaner Studentebond for being in uniform: not the sort of action I was interested in. When I pressed them they would shake their heads.

‘It’s 1960,’ I was told, ‘the war’s been over for fifteen years. You don’t have to worry about that stuff anymore. Let’s have some peace and quiet.’

So I kept quiet and read my war books and tried to make sense of what was going on in the newspapers. The pictures showed police in their flat caps bending over untidy shapes of clothing. The faces were turned away, but I recognised those shapes from pictures of other battlefields. I read the headlines and tried the name ‘Sharpeville’ on my tongue. It didn’t have the same ring as Normandy or Dunkirk, but it meant something to the adults, that was certain, as they sat on the veranda and talked and smoked through the hot evening.

‘There’s going to be trouble, fighting,’ someone said, and I shivered, imagining rubble and tanks rolling through the streets. In the morning as we were being driven to school I stuck my head out of the car window, scanning the sky for aircraft. The other kids sang along with the radio:

‘Weatherman

tell us

– da-dang –

what’s new,

what is the weather going to do?’

There was nothing to see but the morning sun, bouncing off the bay’s calm.

It was only when my mother took us shopping in town, the sky black over the buildings before the afternoon thunderstorm, that I began to notice. Lots more cops than usual, elbowing back the unfamiliar weight of their slung rifles. The black people on the streets looked different too: quiet, and walking close to the walls as if they didn’t want to attract attention. The police stopped them, lined them up and held out their hands for passbooks. It had a familiar look, like a scene from a movie about the German occupation in France. At the same time I was unimpressed because the cops didn’t look like real soldiers and their voices cracked as they shouted.

‘Kom, kaffer,’ they screamed. ‘Wys jou pas!’ and I realised how tense they were.

‘It’s because there’s trouble in the Native locations,’ I was told by my friend Rolie. ‘It’s because the Zulus hate the Indians; always have.’

He and his mates suddenly appeared much better informed than I, who only heard evening talk that I wasn’t supposed to be listening to, about vague things like ‘the political situation’. My school-friends didn’t know anything about the political situation – probably didn’t know there was one – but they knew about rampages and massacres, had heard their parents talk about black servants who crept silently up the stairs of the white homes each night, carving knife in hand, to check that everyone was asleep.

‘My father told me all about it,’ said Rolie. ‘He was there in ’49 during the riots when they burnt the Indian shops. He was called up from the reserves, and they gave him six bullets and a rifle and put him on patrol in Umgeni Road. He said it was the women, the Native women, who stirred it all up, running in front with sticks, making that noise with their tongues. It’s just a matter of time before they turn on us.’

And so they went on, comparing rumours, boasting about the size of their fathers’ guns, while I listened, perplexed, wondering whether I lived in another country. There was no talk of rifles or homicidal servants at our dinner table, hardly any talk at all that I could follow, but in the evenings the murmur of voices would rise from the terrace below my bedroom, over the sound of trains shunting down at the docks. I leaned on the veranda rail watching the cigarettes glow: Mike and Shirley, Rose and Louie, all those young couples, ice tinkling in their glasses, asking my father about England where he’d been demobilised from the army after the end of the war.

‘Oh, it’s not so bad there, you know.’

‘I couldn’t bear it, too cold…’ and the women would stand watching the moon rise over the bay with the pressure of that thick, still air on their faces.

The air in Durban had a special embrace, a humidity that held the scent of turmeric and coated your body like honey. Flamingos used to come each year to wade on the mudflats in the bay, near the black whaling ships at anchor with their harpoon-guns shrouded. I imagined it must be very different in Europe, which was the setting of the war books that filled the Adventure section of my local library. I read them late into the night while outside the rainy-season downpour drummed on the giant leaves of the elephantear plants and awoke the belling of the tree-frogs. The books were generally about English heroes. I met one once, a legendary World War Two fighter pilot whose biography I’d read over and over. He had lost his legs in a peacetime training crash and was being rehabilitated on metal limbs when the war began. Convincing the Royal Air Force to let him fly again, he led a Group of fighter squadrons against the Germans. He was shot down over France, leaving one of his tin legs behind in the cockpit as he parachuted out, and a spare had to be dropped to him in the camp where he’d been imprisoned. He’d made several attempts to escape, ending the war in the fortress-prison of Colditz. Now the man used his free time to campaign internationally for the care of the disabled; encouraging them, raising money and awareness.

This work brought him to South Africa, to visit the residential handicapped centre in Durban where my father was staff orthopaedic surgeon. I was let off school to meet him. After being shown round and talking to the kids in their wheelchairs, the ex-group-captain sat at a table under the flame lily trees and sucked on his pipe and signed my copy of his book. Back at school my teachers, deeply envious, wanted to know everything about him. They came mostly from England and felt at home in Durban, they said, because this ex-colonial capital on the Indian Ocean reminded them of what Britain had been before standards had declined. Our headmaster had been a prisoner of war – we credited him with many daring, unsuccessful escapes – and wore a tweed jacket and cravat despite the heat. In a locked drawer of his desk he kept a real pistol, which he sometimes showed to groups of deserving boys.

My father had served in the war as a surgeon, treating wounded soldiers in tent field-hospitals. During the desert campaign in North Africa he had watched the barrage flame from horizon to horizon at the battle of El-Alamein, before the arrival of the first ambulances heralded a flood of casualties on which he and his colleagues worked beyond exhaustion. They’d occupied the lulls between battles, or treating wounded from skirmishes and air-raids, with equal application. Among the books in our study was one written by a group of brother medical officers, dated 1943, called Now There’s a Thing: A Manual on the Philosophy and Practice of Liar Dice. It described lengthy engagements of dare and deception through medical, military and literary allusions, and was extremely funny. Chapters profiled the strategies of maestros of the game; one sketch showed someone who looked like my dad observing a throw through the smoke of his cigarette, dark hair combed back and a captain’s pips on the shoulders of his rumpled bush-shirt.

His civilian orthopaedic practice now must have been less intense, but it was often the case that he’d come home from the hospital only after midnight, or be called away during dinner to deal with an emergency. I had a limitless belief in my father’s abilities, enhanced by the mysterious kit of clinking bottles he carried in his car-trunk containing powdered plasma, for emergency infusion at the scene of a major accident. His consulting rooms were high in a granite building in downtown Durban, with his name in black on the frosted glass door and a bee-hive-shaped jar of sweets in his desk drawer that my brother and I were allowed to raid when we came to visit. From his window we could look down over the colonial heart of the city; the steps of the old post office where Winston Churchill had addressed the people of Durban after his escape from the Boers in 1900, the city hall flanked by cannons, and the palms around the war memorial with its relief of a mourning angel and the ranks of names. These were all white men’s names. The black dead – many had served in the war, as drivers and in labour battalions and other roles that did not involve the carrying of arms – were unlisted. The first story I’d learned of a local war hero, however, was that of Lucas Majozi, a Zulu stretcher-bearer who had gone out under fire at El-Alamein again and again to bring in the wounded despite being wounded repeatedly himself.

It was the war that had taught my father his operating skills. Those years had brought enormous medical advances: in the treatment of shock, in antibiotics, blood transfusion and most significantly in reconstructive surgery, an area in which he’d come to specialise. One afternoon a German lady was brought by a visiting doctor to our house for tea. She’d had her hands blown off when the Hamburg munitions factory in which she had been working had been bombed in 1944. German surgeons had carried out a pioneering reconstructive operation, separating the long bones of her forearms and repositioning tendons so that the muscles performed new movements. Instead of lying together, the bones could now be opened and closed like a crab’s claws, allowing her to pick up her cup, place a biscuit between her lips. We sat around the tea table in the garden and I stared aghast as my dad touched those creepy appendages and felt the muscles flex as they pinched.

‘That’s beautiful,’ he said. The German lady was pretty – she’d been a girl when the injury happened – and suddenly I saw her blush.

The orthopaedic work he did for the handicapped centre involved similar reconstructive techniques. Most of the children suffered from muscle spasticity due to cerebral palsy, and my father would perform tendon transfers – he’d explain to me the operations required, pointing out the muscles on my own skinny arms and legs – loosening contractions and shifting the pull of one over-active muscle to counter another so that a limb could be made straight; that’s what the Greek word orthos meant. He addressed medical conferences on the surgical treatment of spinal tuberculosis, to straighten backs crooked by bone collapse and take pressure off the spinal cord. For the Zulu leprosy patients at the sanatorium up the coast he carried out operations to correct deformities caused by nerve damage from the disease. We always knew when he’d been working there, for – despite his knowledge of leprosy’s low infectivity – he would fend off our greetings and step out of his work-clothes in the upstairs passage that led from the garage, in order to shower and change before joining us at the dinner table.

My mother usually came home smelling of disinfectant. She was a pathologist, working at the medical school. Pathology was as fascinating as surgery but more solemn, because it was about death. One of the heads of her department was carrying out research into the techniques of suicide favoured by each of the city’s ethnic groups. Black men cut their throats. Black women drank bleach. Indian women set themselves alight, the men hanged themselves. White women took overdoses, while the most popular technique for white men – apart from a brief vogue of looping a rope round the neck, tying the other end to a tree, and driving off at speed – was their readily-to-hand firearms.

There were two kinds of white people, English and Afrikaans. The latter spoke a different language; also, while we had been fighting the Germans in World War Two, the Afrikaner opposition party headed by Dr Malan (a Doctor of Divinity, I was relieved to note, not of medicine) had wanted a Nazi victory. Afrikaner students attacked soldiers on leave. My mother had been at Pretoria University at the time, while her brothers were serving in North Africa. She remembered some of her classmates giving the Hitler salute, and the night a sabotage group had derailed a troop train by blowing up the line where it ran through the veld near her family home east of the city. Now the Afrikaners ran the country and made the laws, and the political discussions among my parents and their friends involved a certain seriousness of tone that tended to set them beyond the understanding of children.

Then politics came into our lives. A state of emergency was declared and police trucks roared late at night along the road that led past the university and down the back of the Ridge. I’d once been down there all the way to the end, where the tarmac became patchy and pot-holed and lights on poles lit the gates of the Cato Manor Native Township. I would hear the trucks returning, engines groaning up the hill, and I imagined the prisoners looking through the wire mesh at our house as they were driven past, seeing our lights, and wondered what they felt. Sometimes in the distance there would be sounds like gunshots. In the mornings the road was always empty, with the smell of wet tarmac in the rising heat.

It had rained that morning, making the classrooms dark and forcing us to spend our lunch-break under the dripping trees. Slate-coloured clouds heaped up behind the Ridge and the close air promised more rain on the way. We were back upstairs at our desks when we first heard it; a sort of deep, droning hum that came from far off, filling the room. We looked at Miss Charles, who stared at the buzzing windowpanes with a frown. The doorknob rattled sharply and the teacher leapt up, her face fixed in a rigid smile. She wrenched at the handle, keeping her pale face turned to the class; to comfort us, perhaps, or to prevent an outburst of giggling. The door opened a few inches and the headmaster’s hand came through the gap, groping like a blind man’s, while he kept up an urgent conversation with someone outside.

‘Phone the parents,’ we heard him say. ‘Tell them to stay at home. The major said it’s safest if we remain indoors.’

Then he began to murmur to Miss Charles, who clasped her hands to her chest and looked as if she were going to faint. The boys started to whisper. Some of the girls were drawing shaky breaths and one or two began to cry. Meanwhile, the noise in the distance had risen, become a steady, muted roar. Outside, tyres slid on the wet road. Orders were shouted, boots thumped on the pavement.

‘It’s the Natives,’ declared my friend Rolie, ‘they’re coming,’ and we rushed to the door that led out onto the balcony. Behind us Miss Charles, her legs weighed down by clumps of wailing girls, shouted for us to come back.

We packed the railing, pulling ourselves up to see. The street was full of activity and an assortment of vehicles; ivory-coloured police trucks, traffic-cop motorcycles and a blue bus with wire grilles on the windows were parked randomly across the roadway. The men had been formed into a line below us, naval blue beside policeman grey. They held rifles across their chests and looked from side to side at the men at either shoulder. The motorcycle cops in their boots and jodhpurs clutched pick-handles and fiddled with their pistol-holsters. Grim is the word, I thought, they look grim; but they shifted constantly in their straggling line, swallowing and swallowing. We could feel the plucking hands of the teachers as they tried to get us back indoors, hear their panted orders, but we eluded them, gripping the rails. The line of men began a stiff-legged walk down towards the corner where the street to the school turned up from the main road.

The distant sound had become a collection of individual shouts, a fragmented chanting. We leaned out as far as we could, craning our necks to see what was coming. The cordon of police and soldiers stood with their backs to us, blocking off our street. The sky shifted a notch further towards darkness and the leaves moved sideways in the cool gust before the rain. Suddenly there came the plaintive peep of a car-horn and the ranks divided around a small green Morris that chugged up the road towards the school.

‘Hey, Raymond, it’s your mom,’ shouted someone, ‘she’s come to get you!’

We could see her anxious face peering up at us through the windscreen as the car wound like a toy between the parked trucks. Raymond flung himself back from the scrum. We heard his shoes clatter down the stairs, his whimpered argument with the woodwork master who guarded the gate below. Then he broke free and hurled his satchel before him through the open window of the moving car, following it in a graceless dive. We watched his thin legs kicking, socks around his ankles, as the little car ground up the hill towards the Ridge.

The rain started, wetting our faces, but none of us took shelter, for a shout had come from the corner. We held our breaths. A shudder seemed to run down the line of men – a collective flinch – as the space beyond them was suddenly filled. One moment we could see the wet roadway between their shoulders and the next it was gone, swallowed up by people, by a mass of dark faces and white shirts, of overalls and umbrellas. I had never seen so many black people at one time; could there be that many in the whole country? The words of their chant came to us clearly. It was in Zulu, strong and deep, familiar sounds that we’d heard around us all our lives. Probably none of us could understand more than a word or two, asking each other: ‘What are they saying?’

Rolie nodded sagely. ‘You see, it’s the women, just like I told you. Whipping them up.’

I listened, but I heard no women’s voices, or rather, no voice that stood out clearly enough to say for sure. And no-one really seemed whipped up as they moved past the line of guards, not even glancing at them. Now and then a group would rise up in a sort of bounding dance and then be swallowed again among the crowd, while the mass of people that filled the street continued by, steadily. The warm rain made everything misty, diffused, as though there was glass between us and what was happening. Even the teachers had stopped their fretting and stood there with the rest of us, lost in contemplation of this great gathering of strangers in our midst. Perhaps for some of them – for some of us, even – there was a realisation that we might be seeing the future.

When my mother came to pick me up she was glowing with a quiet delight. ‘It’s happening all over town,’ she said. ‘I drove right through the crowds. There was no violence, they were perfectly orderly, making way for me. Perhaps there’s hope, after all.’

‘You were lucky,’ I informed her, excited and scared by what I had seen. ‘My friend Rolie said they were going to kill us.’

She looked at me, her face suddenly sad.

‘Don’t listen to those boys,’ she said.

The next day we got an armoured car outside our house. It sat square on the patch of grass beneath the streetlamp, its lugged tyres taller than I was, and the gun in the turret pointed up along the road that rose towards the stone gateposts of the university. The vehicle’s steel plating had a rough, top-heavy look; too thin, to my well-read eye, to stop anything larger than a two-pounder. The crew were conscripts, I could tell by their shoulder-flashes. Bored, contemptuous, lonely, they sat in their places watching along that strip of tarmac where the heat made flowing lines like water. They may have wondered what it was that they were supposed to be facing, been afraid some of the time, but they were never in doubt of their purpose in being there. They were the front line. They wore pouches of khaki webbing, the same stuff that my dad had brought back from the war, but his old pack that hung behind my bedroom door was sun-bleached and stained with the ghosts of oil-puddles from the streets of Naples and the quays at Port Said. The equipment of these soldiers was stiff and new. I pitied them, that they had seen nothing; would see nothing, for the road stayed obstinately empty.

The following morning they were still there, so I brought them mugs of tea. They let me sit in the turret and swing the machine gun in lazy, inertial arcs. I studied them, their cocksure boredom, and listened to them talk about their homes and the families they were defending. The driver, sitting in the hull of the armoured car, had a transistor radio on the edge of his hatch and I could hear him singing:

‘whether it’s cloudy

or wet or shine,

if you keep on smiling

it’ll turn out fine.

Give a man a Lucky…

– dang-dang –

Lucky Strike!’

I was unable to believe that I would ever have a part in a war like this, a war against nothing. No enemy tank, grey and low, would slide its barrel between those gateposts. Only people, walking in their thousands, if they ever came again. At night there was a far-off crackling, the suggestion of a red glow in the sky behind the Ridge, and I thought of the soldiers looking at each other in the dark, listening from within the confines of their cooling armour. Apart from an occasional car returning from a cocktail party in the suburbs, the only things that moved out there were the looping shadows of the flying ants around the white streetlight.

The state of emergency was arresting anyone who was active in politics, and some of my parents’ friends started to leave. Rose and Louie decided to give it all up, to go to England or perhaps America. They told us about it over drinks, looking out over the lights reflected in the bay like emigrants dreaming of the Promised Land. On Sunday we went to see them off at the airport. The armoured car had gone during the night, leaving behind cigarette ends and some great rips in the grass, and our Humber rolled down deserted streets past sprinklers that watered the green verges. The black domestic workers, who usually could be found sitting there on their day off in talkative groups, were nowhere to be seen.

The road to the airport skirted the docks and the shunting yards and the quay where the old war-time flying-boat base had been. There were still a couple of derelict Sunderlands, sunk in the shallows. Their wings tilted from the water, shedding white flakes of paint and seagull shit, and I imagined them taxiing out before the dawn in sheets of spray to lift off on patrol, looking for enemy submarines far beyond the place where the brown silt of the river-mouths stained the sea fifty miles out.

The walls of the airport cafeteria were decorated with miniature propellers. We ordered tea that came in thick white cups. I’d asked for a meat pie and was watching the Worcester sauce soak through the crust when the flight was announced. The women embraced, crying. Then Rose hooked her bag over her shoulder and Louie put his arm around her and they walked through the glass doors to where the propeller-wash flattened the grass. We watched the plane bank over the green wall of the Bluff and fly north until it was out of sight.

There was silence for a while on the way back, apart from my mother’s sniffing. I touched her shoulder and she gave me a brief smile. She turned to my father.

‘Elaine’s going too, and the Epsteins. I’m going to miss them terribly.’ She squeezed his arm below his rolled-up sleeve. ‘We’ll be all alone soon. Who’s left?’

‘Lots of people. I don’t know.’

They looked at each other doubtfully.

‘Well, let’s find out. We’ll have a party,’ he suggested, and they began to discuss whom they could invite, what the theme should be.

‘The Wandering Jew.’

My mother giggled. ‘Don’t be gauche.’

‘Well, look at us; all scattered again, pulling up roots.’

We drove past the shunting yards, jolting over the tracks that ran across the road. They disappeared into the side of a vast, hollow building that had been built to store flour. There was always a light on at the top of one of the towers, behind a dusty window, and I was trying to get my head down far enough to see whether it was there today when I heard my father’s sudden intake of breath, like a hiss. Ahead of us the pavement was filled with people pouring out of the gates of the ‘Non-Whites Only’ football ground. Sports matches weren’t allowed on a Sunday, so they must have been at a meeting. After the march I’d witnessed, I couldn’t understand why there weren’t hundreds of cops around.

‘There’s not much property here to protect,’ said my dad. He pointed at the vacant lots. ‘There’ll be plain-clothes men among the crowd.’ We bumped onto the bridge and he slowed the car to a crawl. Around us the people spilled onto the roadway, closely packed, yet here and there bodies leapt and jostled and ran forward a few steps in unison just like the fluid dance I had seen from the school balcony. The men wore coats and hats, some of the women had black and green cloths tied around their waists. Again I wondered where all these dark faces came from, where they lived: in the hills behind the city, or in the servants’ quarters tucked at the bottom of the gardens of the big white homes?

On the bridge there was a violent stir, a surge against the rails, and a man fell into the gutter. At once the crowd broke like a wall, all in the same direction. I thought of air raids, of panicked crowds. The sealed car windows and the rustle of the air-conditioner blocked out all sound. The man in the gutter had pale yellow socks and he lay on his back, one shoe and slender ankle pointing above the curb at the sky. We sat there, vulnerable, ignored, while around us the silent rush continued. I grasped a handful of my father’s shirt, feeling the tension in his shoulder muscles. No-one looked at my white face pressed against the glass.

The party was a success. Among those that were leaving and the ones who were staying there was the same tense gaiety, a determination to be happy, and some drinks soon had everyone in a fine mood. I met an uncle of mine, a handsome man